<h2 id="feedback-title">{{translate 'title'}}</h2>
<div id="feedback-overview" class="instruction">{{translate instructionKey instructionUrl=instructionUrl}}</div>
<form id="feedback-form" action="/direct/feedback/{{siteId}}/{{url}}" method="POST">
    <div id="feedback-mandatory-instruction" class="instruction">{{translate 'mandatory_instruction'}}</div>
    <fieldset>
    <div class="feedback-form-field">
    	<label for="feedback-title">{{translate 'title_label'}}</label>
    	<input id="feedback-title" type="text" name="title" maxlength="40" size="40"/>
    </div>
    <div class="feedback-form-field">
    	<label for="feedback-description">{{translate 'description_label'}}</label>
    	<textarea id="feedback-description" name="description" cols="80" rows="5"></textarea>
    </div>
    <div id="feedback-sender-address-wrapper" class="feedback-form-field">
    	<label for="feedback-sender-address">{{translate 'sender_address_label'}}</label>
    	<input id="feedback-sender-address" type="text" name="senderaddress" size="40"/>
    </div>
    
    <input id="feedback-destination-email" value="{{destinationAddress}}" hidden="hidden"/>
    <input id="feedback-contactname" value="{{contactName}}" hidden="hidden"/>
    <input type="hidden" name="siteExists" value="{{siteExists}}"/>
    <input name="plugins" value="{{plugins}}" type="hidden"/>
    <input name="screenWidth" value="{{screenWidth}}" type="hidden"/>
    <input name="screenHeight" value="{{screenHeight}}" type="hidden"/>
    <input name="oscpu" value="{{oscpu}}" type="hidden"/>
    <input name="windowWidth" value="{{windowWidth}}" type="hidden"/>
    <input name="windowHeight" value="{{windowHeight}}" type="hidden"/>
    <div id="feedback-attachments-label">
        <span>{{translate 'attachments_label'}}</span>
        <span id="feedback-max-attachments-label">
            <span id="feedback-max-attachments-mb"></span>
            <span id="feedback-attachments-max-suffix">{{translate 'attachments_max_suffix'}}</span>
        </span>
    </div>
    <input id="feedback-attachment" name="attachment" title="{{translate 'attachments_select_attachment'}}" type="file" class="multi"/><br clear="all"/>
    <div id="feedback-recaptcha-wrapper">
        <div>Enter the text that you see in the box below:</div>
        <div id="feedback-recaptcha-block"></div>
    </div>
    </fieldset>
    <div class="act">
        <input id="feedback-submit-button" class="active" type="submit" value="{{translate 'submit_label'}}" />
        <input id="feedback-cancel-button" type="submit" value="{{translate 'cancel_label'}}" />
    </div>
</form>
